ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Evaluate the Effect of Cresemba (isavuconazonium Sulfate) Capsule and Noxafil (posaconazole) Delayed Release Tablets on Tacrolimus Dose to Concentration (D/C) Ratios in Lung Transplant Recipients

H. Sweiss1, E. Kincaide1, D. Levine2, R. Hall1

1University Health, San Antonio, Department of Pharmacotherapy and Pharmacy Services, The University of Texas at Austin, Pharmacotherapy Division, College of Pharmacy, San Antonio, TX, 2University Health, San Antonio, University of Texas Health Science Center at San Antonio, San Antonio, TX

Meeting: 2021 American Transplant Congress

Abstract number: 153

Keywords: Drug interaction, Fungal infection, Lung, Pharmacokinetics

Topic: Clinical Science » Pharmacy » Non-Organ Specific: Pharmacogenomics / Pharmacokinetics

Session Information

Session Name: The Metabolism Milleu: Updates in Pharmacokinetics and Pharmacogenomics

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 6, 2021

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:15pm-6:20pm

Location: Virtual

*Purpose: Evaluate the effect of Cresemba (isavuconazonium sulfate) capsule and Noxafil (posaconazole) delayed release tablet on tacrolimus dose to concentration (D/C) ratio in lung transplant.

*Methods: This retrospective review included adult lung transplant recipients at University Transplant Center from 1/1/2017-10/1/2020. Patients received concomitant therapy of immediate-release tacrolimus with one of the following triazoles for antifungal prophylaxis or treatment of invasive fungal disease for a minimum of 7 days: posaconazole (PSZ) delayed release (DR) tablet or isavuconazonium sulfate (ISV) capsule. A matched pair analysis compared the following outcomes pre-triazole initiation and 7-30 days post-triazole initiation: tacrolimus trough (mg/dL), total daily dose of tacrolimus (mg), total weight-based total daily dose of tacrolimus (mg/kg), and tacrolimus D/C ratio. In addition, percentage change in tacrolimus D/C ratio was calculated pre- and post-triazole initiation.

*Results: Fifty lung transplant recipients were screened for inclusion in the study, with 41 patients meeting study criteria. A total of 34/41 patients received PSZ DR tablets (Table 1). Of these patients, 22/34 were transitioned from previous triazole therapy to PSZ DR tablets and experienced a 47% reduction in tacrolimus D/C ratio after conversion to PSZ DR tablets. Twelve patients were newly initiated (de novo initiation) on PSZ DR tablets and experienced a 50% reduction in tacrolimus D/C ratio post-triazole initiation. A 35% reduction in tacrolimus D/C ratio was observed when transitioning to ISV from previous triazole therapy (P=0.69) (Table 2).

*Conclusions: This data suggests when initiating patients on PSZ DR tablets or converting from a previous triazole, a tacrolimus dose reduction of approximately 50% is required. Although there was not statistical significance, switching from a previous triazole to ISV may require less of a tacrolimus dose reduction. More patients would need to be gathered to see if this holds true. Limited evidence exists to navigate tacrolimus dose adjustments with de novo initiation and converting between triazole antifungals. This study provides guidance on management of tacrolimus dosing when initiating newer triazole antifungal agents.

 border=

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Sweiss H, Kincaide E, Levine D, Hall R. Evaluate the Effect of Cresemba (isavuconazonium Sulfate) Capsule and Noxafil (posaconazole) Delayed Release Tablets on Tacrolimus Dose to Concentration (D/C) Ratios in Lung Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/evaluate-the-effect-of-cresemba-isavuconazonium-sulfate-capsule-and-noxafil-posaconazole-delayed-release-tablets-on-tacrolimus-dose-to-concentration-d-c-ratios-in-lung-transplant-recipients/. Accessed May 16, 2025.

« Back to 2021 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences